Human papillomavirus (HPV) is a very common virus that can lead to cell changes in the cervix. HPV is spread through skin-to-skin contact and is extremely common – most sexually active people will get it at some point. In most cases, HPV goes away on its own without causing any health problems. However, sometimes it persists and causes abnormal cervical cell changes called cervical dysplasia. Cervical dysplasia is precancerous and in some cases, can progress to cervical cancer if not treated. So while an HPV infection itself is not dangerous, the cell changes it causes can potentially become cancerous. Here is an overview of what to know if you have HPV and abnormal cervical cells.
What causes cervical dysplasia?
Cervical dysplasia is caused by an infection with certain high-risk strains of HPV. The strains that are most likely to cause dysplasia are HPV 16 and 18. When these strains infect the cervix, they can cause the cervical cells to become abnormal and multiply in an uncontrolled way. Over time, these abnormal changes can progress from mild (low-grade lesions) to moderate or severe (high-grade lesions). Low-grade lesions are less likely to become cancer, while high-grade lesions have a higher risk of becoming cancer if left untreated.
What are the symptoms?
The tricky thing about cervical dysplasia is that most of the time, it does not cause any symptoms. Abnormal cells on the cervix generally do not cause pain or discomfort. Sometimes there may be symptoms like:
- Unusual vaginal discharge
- Bleeding between periods or after sex
- Pelvic pain
However, many women have no symptoms at all. This is why getting regular Pap tests is so important – it allows detection of abnormal changes before they progress or cause problems.
How is cervical dysplasia diagnosed?
Cervical dysplasia is most commonly discovered through Pap smear screening. A Pap smear is a routine test in which cells are gently scraped from the cervix and examined under a microscope. If abnormal cells are seen, further testing like a HPV test or colposcopy may be recommended. These additional tests can determine the severity of the abnormal changes.
Steps in diagnosing cervical dysplasia:
- Pap smear shows abnormal changes in cervical cells.
- HPV test checks for high-risk HPV strains.
- Colposcopy uses a magnifier to examine the cervix in more detail.
- Biopsy takes a small sample of tissue to be examined.
These tests together will determine whether dysplasia is present, and if so, whether it is low-grade or high-grade.
What is the treatment?
Treatment of cervical dysplasia aims to remove or destroy the abnormal cells before they progress to cancer. There are a few options:
- Cryotherapy: Freezes and destroys abnormal cells.
- LEEP: Uses an electric current passed through a thin wire loop to remove abnormal tissue.
- Cold knife conization: Surgical removal of a cone-shaped piece of tissue from the cervix.
- Hysterectomy: Removal of the uterus and cervix (severe cases).
Treatment is very effective at eradicating dysplasia before it becomes cervical cancer. Regular follow-up with Pap smears is important after treatment to monitor for recurrence.
What is the prognosis if treated?
With appropriate treatment, the outlook for cervical dysplasia is excellent. Precancerous changes found in early stages can be removed very effectively. After treatment, patients typically undergo Pap smear follow-up every 3-6 months. As long as Pap smears remain normal and HPV tests are negative, the risk of progression to true cancer is very low.
Even in cases of high-grade dysplasia, treatment is nearly 100% effective at preventing cancer if caught early. The key is detecting dysplasia before cancer develops. As long as Pap smear screening is done routinely, most cervical dysplasia can be found and treated before becoming invasive cancer.
Should I be worried?
An HPV infection or mild cervical dysplasia (low-grade lesion) does not mean cancer is inevitable. In fact, the immune system clears HPV naturally in most women within 1-2 years. Minor cell changes often regress and resolve on their own without needing treatment. However, any finding of moderate or severe dysplasia (high-grade lesion) does warrant treatment since the risk of progression to cancer is higher.
Some key points:
- HPV alone without dysplasia: No need to worry, but should follow-up with Pap smears.
- Mild dysplasia (CIN 1): Very low cancer risk, often regresses on its own.
- Moderate dysplasia (CIN 2): Should be treated due to higher cancer risk.
- Severe dysplasia (CIN 3): Highest risk of progressing to cancer, needs treatment.
The bottom line is that regular screening and following your doctor’s recommended treatment plan is crucial. While cervical dysplasia is common, it is preventable from turning into cancer with the right follow-up care.
Can cervical dysplasia recur after treatment?
In some cases, cervical dysplasia can recur after initial treatment. Recurrence rates depend on the severity:
| Dysplasia Grade | Recurrence Rate |
|---|---|
| CIN 1 (mild) | 10-30% |
| CIN 2 (moderate) | 10-40% |
| CIN 3 (severe) | 10-50% |
There are a few reasons recurrence may happen:
- The abnormal tissue was not entirely removed during initial treatment.
- The woman becomes re-infected with HPV after treatment.
- The woman has a compromised immune system that cannot fight off HPV.
To lower recurrence risk, it’s important women:
- Get regular Pap smears to catch any recurrence early
- Follow up with HPV testing as recommended by their doctor
- Consider getting the HPV vaccine if they haven’t already, to prevent future reinfection
- Avoid smoking, which can increase risk of recurrence
Conclusion
Having HPV or mild cervical dysplasia can certainly cause worry, but try to keep perspective. In most cases, it will not lead to cancer as long as proper follow-up care is obtained. Listen to your doctor’s recommendations for management, screening, and treatment. Discuss all your concerns and questions to make sure you understand what each test result means. With close monitoring and early intervention, the prognosis for both HPV and cervical dysplasia is excellent. Maintaining regular OB-GYN appointments is key, even after treatment is complete.